Objective To investigate the pathogenesis and harm of secondary epilepsy in parasagittal and parafalcine meningiomas and effective measures for preventing and reducing tumor-related epilepsy.Methods A retrospective analysis was performed for the clinical data of 23 patients with parasagittal and parafalcine meningiomas who were hospitalized in our department from March 2011 to June 2016 and underwent surgery.The surgical methods for tumors with different features and the incidence of secondary epilepsy were compared.Results All patients underwent surgical treatment,among whom 19 underwent grade I tumor resection and 4 underwent grade Ⅱ tumor resection.Of all patients,7 experienced seizures before surgery,1 experienced seizures within 24 hours after surgery,and 5 experienced seizures within 24 hours to 7 days after surgery;there were 5 new cases of epilepsy within 2 years.Three patients developed partial motor aphasia and 4 developed varying degrees of hemiplegia in the contralateral extremities.The chi-square test showed that the presence or absence of peritumoral edema (P=0.007) and whether anti-epileptic drugs were used before surgery (P=0.027) influenced the development of postoperative secondary epilepsy.Conclusions Tumor-related epilepsy is a great harm to patients with parasagittal and parafalcine meningiomas after surgery.Antiepileptic therapy should be given to patients with a history of preoperative epilepsy in the perioperative period,and pharmacological prevention and treatment should be provided to high-risk patients with marked peritumoral edema,intraoperative cerebral contusion,and vein injury.